Objectives To evaluate the maternal and neonatal outcomes of expected and unexpected pathologically proven placenta accreta spectrum (PAS) cases in a single multidisciplinary center. Material and Methods This was a retrospective cohort study of 92 PAS cases from January 2011 until September 2021. Only cases with histopathologically invasive placentation were included in the study. The cases diagnosed at the time of delivery were defined as unexpected PAS (uPAS) and those diagnosed antenatally as expected PAS (ePAS). Maternal and neonatal outcomes of both groups were compared. Results Thirty-five (38%) of 92 cases were in the uPAS group. Placenta previa and high-grade PAS (percreata) were significantly higher in the ePAS group (p=0.028, p<0.001; respectively). The mean packed red blood cell transfusion was significantly higher in the uPAS group (p=0.030) but transfusions of other blood products were similar in the two groups. There was no significant difference in intraoperative complication rates between the two groups. Preterm delivery (<37 weeks) was significantly higher in the ePAS group (p<0.001), but there was no significant difference between the two groups in terms of adverse neonatal outcomes. Conclusions Our single center data show that although ePAS cases include more highly invasive PAS cases, maternal hemorrhagic morbidity is lower than uPAS cases. Reducing maternal morbidity in PAS cases can be achieved by increasing antenatal diagnosis.

Background/aim: Due to the importance of early outpatient treatment to prevent hospitalization and disease progression, we examined the effects of hydroxychloroquine and favipiravir, which were initiated in early period, on the clinical course of COVID-19 outpatients. Materials and methods: Data of confirmed COVID-19 outpatients over a 4-month period were analyzed retrospectively. Public Health Management System (HSYS) was used for the case-based follow-up. Patients on antiviral therapy for at least five days, including hydroxychloroquine and / or favipiravir and patients who were followed-up for 30 days were included in this analysis. Results: We enrolled 1489 patients in this study. Overall, 775 (52%) patients were male and a mean age of patients was 38.9 +/- 11.1 years. Of these patients, 537 of them were received favipiravir, 545 of them were received hydroxychloroquine and 407 of them were received both favipiravir and hydroxychloroquine. Symptoms improvement on the 14th day of follow-up was 1.8 times higher in the group of patients receiving hydroxychloroquine compared to patients who received favipiravir (p = 0.003). On the 3rd day of followup, PCR negativity rate was higher in patients who received hydroxychloroquine (p = 0.004). Hospitalization rates were similar in patients receiving favipiravir and hydroxychloroquine (p = 0.144). However, in the presence of pneumonia at the time of diagnosis, the hospitalization rate was 6.6 times higher in patients who received favipiravir than those who received hydroxychloroquine. Conclusion: The subgroups of patients treated with hydroxychloroquine and/or favipiravir did not have similar disease severities in our study. Therefore, further studies with homogeneous patient groups to be arranged prospectively are needed.

Objectives: This study explores the prognostic relevance of hemogram parameters and derived ratios in stratifying hospitalization levels, including intensive care unit (ICU) admission, using machine learning models. Methods: Clinical and laboratory data were retrospectively obtained from a tertiary-level teaching hospital encompassing a wide range of care settings. Five classification models – Multinomial Logistic Regression, Random Forest, Gradient Boosting Machine (GBM), Support Vector Machine, and Multi-Layer Perceptron Neural Network (MLP-ANN) – were trained and evaluated. External validation was conducted using an independent dataset from affiliated institutions. SHAP (Shapley Additive Explanations) analysis was applied to enhance model interpretability. Results: Among the evaluated models, GBM and MLP-ANN demonstrated consistent performance across treatment categories, particularly in distinguishing outpatient from higher-acuity hospital admissions. SHAP analysis identified eosinophil and basophil counts as key predictors, with eosinophil levels inversely associated with hospitalization intensity. External validation supported the models’ applicability across patient subsets, although multicenter generalizability remains to be established. Conclusions: This study demonstrates that machine learning models trained on routine hemogram data can effectively differentiate hospitalization levels, offering a scalable approach to early clinical risk assessment. Eosinophil count, in particular, emerged as a key variable with consistent predictive power across models, suggesting its potential relevance in acute care stratification. These findings support the integration of hematological parameters into real-time triage systems and pave the way for future research to validate their role in diverse clinical contexts.

Aim: To investigate the effect of of adding oophorectomy on patients who underwent abdominal hysterectomy in the perimenopausal period on menopause, sexual function and mental status. Materials and Methods: The study was designed prospectively. Women who underwent total abdominal hysterectomy and bilateral salpingectomy (TAH+BS) and total abdominal hysterectomy and bilateral salpingo-ophorectomy (TAH+BSO) in the perimenopausal period for benign indications were included in the study. Three months after surgery, menopausal symptoms (such as vasomotor symptoms, vaginal dryness and/or dyspareunia, memory and sleep problems) were investigated. Beck Anxiety Inventory (BAI) scores were investigated one day before the operation and three months after the operation. Results: 51 patients with TAH+BS and 55 patients with TAH+BSO included in study. Vasomotor symptoms and postoperative BAI scores were significantly higher in the oophorectomy group (p<0.001 and p=0.009, respectively). Vaginal dryness and/or dyspareunia, which adversely affect sexual function, were significantly higher in the oophorectomy group (p=0.005). Memory and sleep problems were higher in the oophorectomy group (p=0.009 and p<0.001, respectively). Postoperative BAI scores were found to be correlated with postmenopausal symptoms (vasomotor symptoms, vaginal dryness and/or dyspareunia, memory problems, sleeping disorders) in the TAH+BSO group. Conclusion: Vasomotor symptoms, vaginal dryness and/or dyspareunia, memory and sleeping problems, and anxiety levels were significantly higher in patients who underwent bilateral salpingo-ophorectomy with hysterectomy compared to patients who underwent only hysterectomy and bilateral salpingectomy. It seems useful to inform the patients who are planned for the operation regarding these effects before the decision of oophorectomy.